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Should I Increase Lactulose Dosage For Abnormal Bowel Movements?
Question: Hello doctor,
I am concerned about a change in my BMs.
Because of me taking Lactulose I usually go 5-7 times a day, very soft and big amounts. Usually with no warning or very slightly cramping just before it all goes into my diapers.
In the last two weeks my BMs per day have decreased to 4-6. I also don't have the whole BM in my diapers anymore. There's still initially a rather large amount that goes into my pants but then I get sever cramping for bout ten minutes before the rest comes so I can make it to the toilette.
With those changes I also noticed changes with my inguinal hernia (which is very large and according to my Dr contains a significant amount of my bowels). It now feels more solid and 'full' is the only word I can think of to describe it. It is not generally painful but there's an on and off pinching 'gas pain' feeling. I have that same pinching 'gas pain' feeling in my abdomen and stomach, it was on and off just like in my hernia but today it started to be constant. Pooping does not relieve it. I just went while typing this and had very large BM but the gas pain persists and hernia still feels solid and full.
I increased the Lactulose but the only result was looser poop and more cramping during the BM.
Should I further increase the Lactulose? Is this just a case of 'constipation'. Or is there something going on that I need to worry about?
I might add that I got my ascites drained a week ago and that my belly is already very large and full (23.8lb weight gain since drainage). Though this is quite normal and not unusual (I usually fill up within 9-14 days to my biggest) it might be important.
I am awaiting a answer and thank you in advance.
I am concerned about a change in my BMs.
Because of me taking Lactulose I usually go 5-7 times a day, very soft and big amounts. Usually with no warning or very slightly cramping just before it all goes into my diapers.
In the last two weeks my BMs per day have decreased to 4-6. I also don't have the whole BM in my diapers anymore. There's still initially a rather large amount that goes into my pants but then I get sever cramping for bout ten minutes before the rest comes so I can make it to the toilette.
With those changes I also noticed changes with my inguinal hernia (which is very large and according to my Dr contains a significant amount of my bowels). It now feels more solid and 'full' is the only word I can think of to describe it. It is not generally painful but there's an on and off pinching 'gas pain' feeling. I have that same pinching 'gas pain' feeling in my abdomen and stomach, it was on and off just like in my hernia but today it started to be constant. Pooping does not relieve it. I just went while typing this and had very large BM but the gas pain persists and hernia still feels solid and full.
I increased the Lactulose but the only result was looser poop and more cramping during the BM.
Should I further increase the Lactulose? Is this just a case of 'constipation'. Or is there something going on that I need to worry about?
I might add that I got my ascites drained a week ago and that my belly is already very large and full (23.8lb weight gain since drainage). Though this is quite normal and not unusual (I usually fill up within 9-14 days to my biggest) it might be important.
I am awaiting a answer and thank you in advance.
Brief Answer:
Answer given below
Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.
There is no need to increase the dose of lactulose.
You have mentioned that you suffer from cirrhosis and its complications.
The hernias - both umbilical and inguinal are due to increased pressure in the abdomen secondary to ascites.
As long as they are reducible and not obstructed, they are not worrisome.
Lactulose is given ease bowel movements as constipation can lead to another complication of cirrhosis - called hepatic encephalopathy. The aim is to have 2-3 bowel movements per day.
If you feel the size of the hernia is increased, it could be probably be due to increase in the fluid in the abdomen. You have also mentioned the belly is already very large.
Salt restriction, diuretics and if needed draining the fluid again would be helpful.
Consult your doctor for examination and for the need to drain the fluid.
I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K.
Answer given below
Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.
There is no need to increase the dose of lactulose.
You have mentioned that you suffer from cirrhosis and its complications.
The hernias - both umbilical and inguinal are due to increased pressure in the abdomen secondary to ascites.
As long as they are reducible and not obstructed, they are not worrisome.
Lactulose is given ease bowel movements as constipation can lead to another complication of cirrhosis - called hepatic encephalopathy. The aim is to have 2-3 bowel movements per day.
If you feel the size of the hernia is increased, it could be probably be due to increase in the fluid in the abdomen. You have also mentioned the belly is already very large.
Salt restriction, diuretics and if needed draining the fluid again would be helpful.
Consult your doctor for examination and for the need to drain the fluid.
I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Thank you for the timely answer.
So there is no reason for concern with the change in my BMs and the unusual gas pain?
My hernia isn't 'bigger' it just feels more solid and full. It hasn't felt like this since I developed it, not even at my biggest which I'm still about 10lb away from. Only started feeling like this two weeks accompanied by the change in my BMs and the gas pain.
So there is no reason for concern with the change in my BMs and the unusual gas pain?
My hernia isn't 'bigger' it just feels more solid and full. It hasn't felt like this since I developed it, not even at my biggest which I'm still about 10lb away from. Only started feeling like this two weeks accompanied by the change in my BMs and the gas pain.
Brief Answer:
Answer given below
Detailed Answer:
Yes, there is no need to worry as long as the hernia is not obstructed or strangulated.
If the gas pain is persistent, then you have to consult your doctor to rule out infection.
Let me know if I can assist you further.
Regards,
Dr.R.K.
Answer given below
Detailed Answer:
Yes, there is no need to worry as long as the hernia is not obstructed or strangulated.
If the gas pain is persistent, then you have to consult your doctor to rule out infection.
Let me know if I can assist you further.
Regards,
Dr.R.K.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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